A retrospective analysis over a 20-year period at Memorial Sloan-Kettering Cancer Center disclosed 17 cases of portal hypertension and esophageal varices with welldocumented metastatic liver disease as the primary cause. In an additional two cases, metastatic liver tumor was presumed to be the cause of the esophageal varices; four patients had portal vein obstruction, and four had both tumor and cirrhosis. Of these patients, 65% bled from their varices and 47% developed hepatic coma. Although a relatively rare cause of upper gastrointestinal bleeding in our hospital patient population, portal hypertension and esophageal varices should be considered in patients with massive metastatic liver disease or primary liver tumor.
Kurtz RC, Sherlock P, Winawer SJ. Esophageal Varices: Development Secondary to Primary and Metastatic Liver Tumors. Arch Intern Med. 1974;134(1):50–51. doi:10.1001/archinte.1974.00320190052007
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